Southern California hospitals ranked in surgical safety

A first-of-its-kind national analysis by Consumer Reports found that Southern California's safest hospital for surgery is in Victorville, while its lowest-ranked is located in Whittier.

Desert Valley Hospital on the southwestern edge of San Bernardino County outperformed big-name university and research medical centers across Los Angeles County, scoring a relatively high 63 out of 100 on the magazine's ratings because its patients went without bloodstream infections for 766 days and had 38 percent fewer adverse events during almost 100 surgical procedures, researchers found.

PIH Health, formerly Presbyterian Intercommunity Hospital in Whittier, scored a 26, the second lowest rating statewide. The hospital reported 31 surgical-site infections in 2,228 surgical procedures among its patients between April and December of 2011.

The report looked at how patients fared during and after surgery at more than 2,400 hospitals nationwide, between 2009 and 2011. Scores are based on the percentage of a hospital's Medicare patients who died in the hospital or stayed longer than expected for their procedure in five areas: back surgery, hip replacement, knee replacement, angioplasty, and carotid artery surgery.

Researchers found that up to 30 percent of hospital patients suffer infections, heart attacks, strokes, or other complications after surgery.

Consumers Report also found that the most prestigious hospitals were not the best.

"Well-known hospitals don't always live up to their reputations," the magazine wrote. "Teaching hospitals, thought to represent the nation's best and the recipients of generous federal funding, often fell short in our surgery Ratings. Though some did rate high, on average teaching hospitals performed no better than other hospitals."

But Desert Valley scored a better than average ranking in avoiding complications.

"We're thrilled to be recognized but the attitude we take is there are lots of things we get recognized for," said Dr. Margaret Peterson, CEO for Desert Valley. "We understand the awards are one thing, but we're always trying to achieve that zero number, such as the zero percentage of complications. You're always striving."

PIH Health officials did not return calls for a comment.

Of the 353 hospitals evaluated in California, Sutter Medical Center in Sacramento scored the highest with 67 out of 100. Delano Regional Medical Center in Kern County was the lowest with a 25.

Many of the hospitals across the San Fernando Valley ranked between 36 to 54.

Cedars-Sinai Medical Center in Los Angeles, known for its clinical research and work in medical advancements, disputes the way the score by Consumer Reports was derived. It earned a 54.

Cedar-Sinai officials said it is the only hospital in California -- and one of five nationwide -- to have a 30-day mortality rate better than the national average for five consecutive years for all three of the following key diseases: heart failure, pneumonia and heart attack.

"The scores attempt to combine and weigh different sets of publicly available data into aggregate hospital safety scores and surgical ratings, a methodology that calls into question the validity and usefulness of the information," according to a statement from Cedars-Sinai. "The portion of its report that examines surgical safety also relies on billing claims data submitted to Medicare rather than on clinical data from patient records."

Consumer Reports acknowledges that its scoring system may have shortfalls. But researchers also said hospitals did not make all vital records available. Of the 107 hospitals rated in Los Angeles and San Bernardino counties, 36 did not provide enough information and were not ranked, including those within the Kaiser Permanente Health System.

"We wish we had access to more comprehensive, standardized information, but this is the best that is available," Dr. John Santa, medical director of Consumer Reports Health, said in a statement. "We know the ratings aren't a perfect measurement but we think they're an important first step in giving patients the information they need to make an informed choice. And we hope that by highlighting performance differences, we can motivate hospitals to improve."

Officials there said while ratings and rankings can be helpful, there are limitations that do not tell the full story.

Hospitals that treat sicker patients, for example, may report more complications following surgery," according to a statement from Keck. "Research indicates that academic medical centers attract and treat the most acute cases because of their access to innovative clinical trials and research. Also, larger hospitals tend to report better outcomes, based on patient volume."

But Consumer Reports disputes that claim, saying that hospitals in urban areas and rural areas often can excel.

"We found several urban hospitals that did well despite often serving poorer, sicker patients, including Mount Sinai Hospital in New York and University Hospitals Case Medical Center in Cleveland," according to Consumer Reports. "And rural hospitals actually did better, on average, than other hospitals."

Anne Arundel Medical Center in Maryland scored the highest in the nation on the Consumer Reports list, with a rank of 74 for surgical safety. The worst included the University of Connecticut's John Dempsey Hospital in Farmington, Conn., and South Shore Hospital in Chicago, Ill. Both earned a 17.

The summary of the hospital report can be viewed at consumerreports.org though a paid subscription is necessary to see detailed information.